Family Workshop Registration Form - Kids' Turn San Diego

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Each parent must complete their own registration form. Spanish translation available upon request.

At this time, Kids’ Turn San Diego continues to offer our Family Workshop for Separated and Divorced Families VIRTUALLY. The VIRTUAL program IS A COURT-APPROVED CO-PARENTING PROGRAM within San Diego County. Click here for the schedule.

Please select the Family Workshop you would like to attend.*
Please select the Family Workshop you would like to attend. Please note our Attendance Policy: Parents are required to attend all four sessions of the same Family Workshop in its entirety to receive a Certificate of Completion. Attendance and participation are monitored during the program. If you miss more than 15 minutes of any class, you will NOT receive a Certificate of Completion and will receive a Letter of Attendance.
Name*
First Last
Gender*
- Female
- Male
- Other
Email*
Ethnicity
(for statistical purposes only)
Year of Birth
(for statistical purposes only)
Mailing Address (We mail program materials to you if you are attending a virtual program. Please provide an address where you receive mail)*
Street Address City State / Province / Region ZIP / Postal Code

Note: Program materials are mailed the week of your program start date. If you move or the above mailing address is not longer accessible, please notify us at info@kidsturnsd.org immediately so we do not mail to the wrong address.
Primary Phone Number*
Note: by adding a phone number to this field (primary phone number) you are acknowledging that it is ok for a Kids' Turn SD staff member to leave a detailed message for you on this number.
Occupation
Company
Co-Parent Information
Name*
First Last
Gender
- Male
- Female
- Other
Co-parent Email

If unknown, check below
- email unknown
Mailing Address
Street Address City State / Province / Region ZIP / Postal Code
Phone #
Information About Your Children
Child 1: First Name*
Child 1: Gender*
- Male
- Female
- Other
Child 1: Age*

If your child is between the ages of 12-18 and will be participating in the program, please provide their email address below.
Child age 12+ Email
Child 1: Birth date*
Child 1: Name of school
Child 2: First Name
Child 2: Gender
- Male
- Female
- Other
Child 2: Age

If your child is between the ages of 12-18 and will be participating in the program, please provide their email address below.
Child age 12+ Email
Child 2: Birth date
Child 2: Name of school
Child 3: Gender
- Male
- Female
- Other
Child 3: First Name
Child 3: Age

If your child is between the ages of 12-18 and will be participating in the program, please provide their email address below.
Child age 12+ Email
Child 3: Birth date
Child 3: Name of school
Child 4: Gender
- Male
- Female
- Other
Child 4: First Name
Child 4: Age

If your child is between the ages of 12-18 and will be participating in the program, please provide their email address below.
Child age 12+ Email
Child 4: Birth date
Child 4: Name of school
I’m attending the Family Workshop (select one)*
- Voluntarily
- Court Order
Please select your court location*
- South County
- East County
- North County
- Central
- Other
- I'm attending voluntarily
Please tell us below how you learned about the Family Workshops at Kids' Turn San Diego. (if more than one source, please list them all)*
How many (total) years were you with your co-parent?
Were you married?
- Yes
- No
How long were you married?
How long have you been apart?
In your opinion, what was the reason for the separation/divorce?
Have you ever served in the military?
- Currently Serving
- Have Served
- Have Never Served in the Military
Has your co-parent ever served in the military?
- Currently Serving
- Has Served
- Has Never Served in the Military
Is a restraining order (RO) or temporary restraining order (TRO) in effect?*
- Yes
- No
If so, who filed for the Restraining Order?
Restraining Order Start date:
MM slash DD slash YYYY
Restraining Order End date:
MM slash DD slash YYYY
Why was it filed? What are the details? (please be specific)
NOTE: If there is a restraining order (RO) or temporary restraining order (TRO) currently in effect, you MUST provide Kids’ Turn San Diego with a copy of the entire court order- and your co-parent will NOT be invited to the same workshop. However, if the box indicating an exception for brief and peaceful contact on the RO is checked and there is a written exception for both co-parents to attend KTSD programs, then both co-parents may enroll in the same workshop. Safety for all KTSD participants is our priority.
Has your family ever been involved with Child Protective Services (CPS)?*
- Yes
- No
When was there CPS involvement?
What was the reason CPS became involved?
What was the outcome of the investigation?
During the Family Workshop, are you concerned about the safety of your children or yourself?
- Yes
- No
If yes, please list your concern(s) for your children and/or yourself during the program:
How would you rate your co-parenting conflict (1 being very low conflict, 10 being extreme conflict)?:
- 1(very low / no conflict)
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10 (extreme conflict)
Please note your % (percentage) of child custody
Special Arrangements
(i.e. curbside drop offs, supervised visits, no overnights...)
Co-parent Custody % (percentage)
Co-Parent Special Arrangements
(i.e. curbside drop offs, supervised visits, no overnights...)
How do you feel your children have adjusted to the divorce / separation? (please be specific for each child)
What do YOU hope to learn at the Family Workshop?
Additional info about your children: Learning disabilities, food allergies, etc: (please specify which child has which learning disability, allergy, etc)
Kids’ Turn provides a small snack for children during the workshop (note: snacks are usually crackers and water).
I give permission for my child(ren) to have snacks at Kids’ Turn San Diego*
- Yes
- No
COMMENTS: Do you have questions or would you like to request an accommodation? (example: NEED SPANISH TRANSLATION, reading is challenging so prefer to read small sections only, unable to climb stairs, need 5 minute stretch break after one hour, etc)
Program Participation Consent
I hereby consent for myself and my child(ren) to participate in the Family Workshop at Kids' Turn San Diego. The purpose of the program is to offer education and support to help children and parents in the process of transition related to separation or divorce. The Family Workshops help your family the most when both parents and children (ages 5-17) attend at the same time. By providing co-parent information, you authorize Kids' Turn San Diego staff to invite your co-parent to the program and communicate your participation. I agree and give my consent for me and my child(ren) to participate in the four session, 10-hour Family Workshop. I understand that, within the bounds set by law, information, communications, observations and opinions derived from this program is considered and confidential. I understand that after successful completion of the program, I will receive a certificate of completion. I also understand that the program may be described in written publications, but that no information will be provided that could identify any individual participants in the program without their written consent. I agree that neither myself nor anyone representing me shall call on any staff persons involved in this program during or after my participation in the Kids' Turn San Diego Family Workshop program to provide either written or oral testimony at a deposition or in court on any issue related to my family. Neither I nor my representatives will subpoena any records from Kids' Turn San Diego for any purpose. I waive any right that I may have to call such person or subpoena such records in this or any action that is or may be filed. Further, all documents produced in the workshop become the property of Kids’ Turn San Diego. I give my consent for Kids’ Turn San Diego to use artwork, images or quotations made by myself and/or my child(ren) in brochures, literature or other public relations activities, but understand that my child will not be identified by full name. I understand that the facility used for the workshop is in no way responsible or liable for any action associated with the Family Workshop program. I understand that the registration payments are non-refundable, but in an extenuating circumstance, I may have my payment transferred for participation in a future workshop. I have signed below indicating that I have read, understand and agree to the above information.
I consent*
- Yes
- Yes, but I have questions. (please note your questions in the comment box below-and we'll call you as soon as possible)
Questions
For payment processing purposes only, please provide your name exactly as it appears on your credit card, check, etc. If someone else is making a payment for you, please provide their name exactly as it appears on their credit card.*
Tuition Payment Options (please select one):*
PLEASE NOTE • Family Workshop tuition is $400 per parent and should be paid in full prior to attending the Workshop. Payment plans are available upon request. There is no additional fee for children to attend. PLEASE NOTE • A deposit is required to secure your space in the Family Workshop and must be paid before the first class. Payments may be made through the "Make a Payment" button on our home page or by calling our office at 858-521-0027. Deposits are non-refundable and will be applied to your tuition. PLEASE NOTE • You do not need a PayPal account to pay online - just a credit card. • If paying by check, please make payable to Kids' Turn San Diego and include the Workshop Number in the memo line. Checks are to be mailed to: Kids' Turn San Diego 4909 Murphy Canyon Rd., Ste. 515 San Diego, CA 92123. We accept personal checks, cashier's checks and money orders. There is a $25 fee for all returned checks. PLEASE NOTE • Payments are able to be made by others on your behalf. If someone else is paying for you by credit card, please email us at info@kidsturnsd.org to notify us of the payment. Please include your name, the Family Workshop Number you are attending, the dollar amount of the payment and the person's name who is making the payment for you. PLEASE NOTE • Tuition Reduction Scholarships are available on a limited basis. All Applications are considered but, due to scholarship availability, not all are approved. To be considered for a scholarship, complete the application in its entirety, including financial information and documentation. Only complete applications will be considered. PLEASE NOTE • Scholarship Applications for Reduced Tuition MUST be submitted at least 2 weeks prior to the start of the Family Workshop. PLEASE NOTE If you have any questions or need assistance, please call our office at 858-521-0027 or contact us via email at info@kidsturnsd.org.
Comments
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4909 Murphy Canyon Rd, Suite 515

San Diego, CA 92123

Kids’ Turn San Diego is a registered 501(c)(3) nonprofit organization.

EIN #33-0724932

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